| Jaiswal Clinic Pllc | |
|
702 Bryan Dr Suite 100 Durant OK 74701-7031 | |
| (580) 924-4704 | |
| (580) 924-6001 |
| Full Name | Jaiswal Clinic Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 702 Bryan Dr, Durant, Oklahoma |
| Authorized Official Name and Position | Deepak S Jaiswal (OWNER) |
| Authorized Official Contact | 5809244704 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jaiswal Clinic Pllc Po Box 1514 Durant OK 74702-1514 Ph: (580) 924-4704 | Jaiswal Clinic Pllc 702 Bryan Dr Suite 100 Durant OK 74701-7031 Ph: (580) 924-4704 |
| NPI Number | 1225296361 |
|---|---|
| Provider Enumeration Date | 05/27/2008 |
| Last Update Date | 02/01/2012 |
| Medicare PECOS PAC ID | 4385717586 |
|---|---|
| Medicare Enrollment ID | O20080722000161 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225296361 | NPI | - | NPPES |
| 1225296361 | Other | GROUP NPI | |
| 1386698728 | Other | OK | INDIVIDUAL NPI |
| 200198250A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Deepak Jaiswal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386698728 PECOS PAC ID: 9537169743 Enrollment ID: I20070222000743 |
| Provider Name | Angela Renee Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043443062 PECOS PAC ID: 5698805273 Enrollment ID: I20110531000684 |
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My Family Healthcare Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1004 N 19th Ave Bldg 2, Durant, OK 74701 Phone: 580-924-5622 Fax: 580-745-5060 | |
Alliancehealth Durant Clinics Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1610 W University Blvd, Durant, OK 74701 Phone: 580-924-3400 Fax: 580-924-2000 | |
University Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1610 W University Blvd, Durant, OK 74701 Phone: 580-924-3400 Fax: 580-924-7732 | |
Jaiswal Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 702 Bryan Dr, Suite 100, Durant, OK 74701 Phone: 580-924-4704 Fax: 580-924-6001 | |
Bryan Medical Center, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1400 Bryan Dr, Suite 211, Durant, OK 74701 Phone: 580-924-2424 Fax: 580-924-2425 |